“Today, Design Council and Frontier Economics published evidence that Accident & Emergency departments could improve patient experience, increase staff wellbeing and save money by implementing a new, proven design solution created by studio PearsonLloyd. Based on this evidence, Design Council recommends that other Trusts adopt the designs.

The two-pronged solution called ‘A Better A&E’ incorporates a ‘Guidance Solution’ – signage to guide and reassure patients, and a ‘People Solution’ – a programme to support staff in their interactions with frustrated, aggressive and sometimes violent patients through communications training and reflective practices.

The solutions have been implemented at two pilot Trusts – St George’s Healthcare NHS Trust in London and University Hospital Southampton NHS Foundation Trust (UHS). The implementation has been rigorously evaluated over the last year. Key findings show:”

“There has been little real attention given to how the NHS estate could help to improve efficiency, move more care out of hospitals and exploit new technologies. This Perspectives piece demonstates how models of care are still designed around buildings, and asks whether re-thinking the way that the NHS uses its estate could catalyse change.”

“The Design Bugs Out (DBO) project aimed to bring designers and manufacturers together with clinicla specialists, patients and frontline staff to help combat infections by making hospital furniture and equipment easier and quicker to clean. This report details the subsequent evaluation of four DBO products.”

“The Department of Health has commissioned The King’s Fund to develop a number of specific programmes to enhance the environment of care as part of its work to improve the patient experience. The latest of these is a programme to improve the care environment for people with dementia to support the implementation of the national dementia strategy.

What are the current issues for people with dementia?

25 per cent of people accessing acute hospital services are likely to have dementia and the number of people with dementia is expected to double during the next 30 years. Hospital stays are recognised to have detrimental effects on people with dementia.

Generally, there is a low level of knowledge in the health professions – even among those who have been trained to care for people with dementia – and among estates and facilities staff about what makes a positive therapeutic environment for people with dementia. The volume of applications for the EHE programmes has shown that there is a considerable level of interest in creating dementia-friendly environments and there is a desire across the service for practical advice to enhance the quality of the care provided to people with dementia.”

There is growing awareness of the importance of the environment within health care. The King’s Fund’s Enhancing the Healing Environment (EHE) programme encourages and enables nurse-led teams to work in partnership with patients to improve the environment in which to deliver care.

This publication describes projects in 19 NHS trusts and one HM prison that took part in schemes to improve the environment of care at the end of life. It describes the broader EHE programme, which has been supported by the Department of Health in a series of publications entitled ‘Improving the patient experience’ and goes on to present case studies of the sites that took part in the programme. Each of the case studies includes photographs of the original space that was chosen for improvement and of the finished project. There are also comments from staff and from users highlighting the importance of the changes to the environment for both the cared for and the carer. The projects show that, even in the most uninspiring environment, it is possible to create welcoming and comfortable spaces that are fit for purpose, good value for money and can improve the quality of care and the patient experience.

The text includes a summary of the independent evaluation of the programme by the University of Nottingham and also a comprehensive project directory, offering details of the individual work carried out in each project, names of artists and others from whom work was commissioned and also project costings.”

“Many California community health centers operate in outdated, inadequate facilities that limit their ability to increase capacity or offer additional services to patients….

Among the design principles demonstrated in … projects:

Ensuring community members are involved in the planning progress;
Creating kitchens, libraries, and other spaces that accommodate community outreach programs, ranging from healthy cooking classes to art education;
Building facilities using sustainable principles and educating communities about these practices;
Integrating standardized exam rooms and other evidence-based planning and design features more commonly found in acute care settings;
Creating larger clinical spaces to accommodate multidisciplinary care and group sessions among a patient, family members, and multiple providers; and
Incorporating telemedicine to provide care from specialists outside the clinic’s walls.

“Capital investment in European health systems has to take account of the demographic and epidemiological transitions associated with an ageing population; advances in medical technologies and pharmaceuticals; rising public expectations; and persistent health inequalities.

This volume presents 11 case studies from across Europe of capital investment in health facilities, in the form of seven individual projects, two health systems, one corporate investor and one financing approach. They include hospitals or medical centres in the Netherlands, Norway, Sweden, Finland, Germany, Poland, and Spain, and regional planning and a financing initiative in the United Kingdom and Italy.

This book offers policy-makers, planners, architects, financiers and managers practical illustrations of how health services can be translated into capital assets and aims to expand the evidence base on how to improve the long-term sustainability of capital investment.”

“Despite considerable investments in health facilities worldwide, little systematic evidence is available on how to plan, design and build new facilities that maximize health gain and ensure that services are responsive to the legitimate expectations of users. This book brings together current knowledge about key dimensions of capital investment in the health sector.

A number of issues are examined, including new models of long-term care, capacity planning, the impact of capital investment on the health care workforce, markets and competition, systems used for procurement and financing, the whole lifecycle of health facilities, facility management, the wider impact of capital investment on the local community and economy, how care models can be translated into capital asset solutions, and issues of therapeutic and sustainable design.

This book is of value to those interested in the planning, financing, construction, and management of new health facilities. It identifies critical lessons that increase the chances that capital projects will be successful.”

The Healthcare Commission has today published a report it commissioned from the NHS Sustainable Development Unit, which looks at the data currently available to support NHS trusts being assessed for carbon reduction monitoring by the regulator. We will be sharing the report’s findings and recommendations with the Care Quality Commission, which becomes responsible for regulating the NHS on 1 April 2009.